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1.
Occup Environ Med ; 74(5): 321-327, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27516111

RESUMO

OBJECTIVES: Mustard gas (MG) has been the most widely used chemical warfare agent in the past century. However, few but conflicting data exist on the effects of MG exposure on long-term mortality. We investigated MG-related mortality in retired workers at a poisonous gas factory. METHODS: We assessed mortality rates among 2392 male and 1226 female workers, whose vital status could be determined through 31 December 2009, at a poisonous gas factory operating from 1929 to 1945 in Okuno-jima, Japan. The analysis employed standardised mortality ratios (SMRs) calculated using national and prefectural references and a Cox proportional hazard regression model. Applying the Kaplan-Meier method, we compared cumulative death rates in the study cohort stratified by an 'Okuno-jima MG Index' which represented the product of HRs derived for job category and length of service. RESULTS: Among male workers, we found significant excesses in mortality from upper respiratory tract cancer (SMR 3.06), liver cancer (1.67), lung cancer (2.01) and chronic bronchitis/emphysema (4.84) compared with the national population, as well as stomach cancer (1.20) versus the Hiroshima Prefecture population. When stratified into 3 subgroups by the Okuno-jima MG Index, those with a higher Okuno-jima MG Index had significantly higher cumulative rates of death from respiratory cancer and chronic bronchitis/emphysema. CONCLUSIONS: MG exposure significantly increases the long-term risk of death from respiratory cancer and chronic bronchitis/emphysema. The Okuno-jima MG Index may be a useful indicator for estimating cumulative MG exposure.


Assuntos
Substâncias para a Guerra Química/efeitos adversos , Gás de Mostarda/efeitos adversos , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Bronquite Crônica/induzido quimicamente , Bronquite Crônica/mortalidade , Causas de Morte , Estudos de Coortes , Atestado de Óbito , Enfisema/induzido quimicamente , Enfisema/mortalidade , Feminino , Seguimentos , Humanos , Indústrias , Japão/epidemiologia , Masculino , Neoplasias/induzido quimicamente , Neoplasias/mortalidade , Modelos de Riscos Proporcionais , Aposentadoria
2.
Arerugi ; 61(6): 820-31, 2012 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-22868522

RESUMO

BACKGROUND AND AIMS: Tulobuterol patch (Tulo) is often used for treatment of elder patient with asthma in Japan. However, there is no evidence either ICS plus Tulo or ICS/LABA combination is better for elder patient. METHODS: Elder patients with asthma (aged≥ 70, n=17) who had treated with budesonide (BUD) 400 µg/day plus Tulo 2 mg/day, were randomly assigned either to change control medication to budesonide/formoterol combination (BUD/FM) 320/9 µg/day or to keep BUD plus Tulo treatment for 12 weeks. RESULTS: At week 4 and week 12, the BUD/FM group showed significant increase in lung function (FEV1, %FEV1) and mini AQLQ score compared with the BUD plus Tulo group. The BUD/FM group also showed decrease in Tumor Necrosis Factor-alpha level in exhaled breath condensate at week 12. No adverse event was observed in both groups. CONCLUSION: In elder patients with asthma, treatment with BUD/FM does not have any clinical disadvantage and may provide better efficacy in lung function, QOL, and possibly anti-inflammation compared with BUD plus Tulo treatment.


Assuntos
Asma/tratamento farmacológico , Broncodilatadores/administração & dosagem , Budesonida/administração & dosagem , Etanolaminas/administração & dosagem , Terbutalina/análogos & derivados , Adesivo Transdérmico , Idoso , Idoso de 80 Anos ou mais , Asma/diagnóstico , Biomarcadores/análise , Testes Respiratórios , Quimioterapia Combinada , Feminino , Fumarato de Formoterol , Humanos , Masculino , Qualidade de Vida , Terbutalina/administração & dosagem , Fatores de Tempo , Fator de Necrose Tumoral alfa/análise
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